孕期期末在怀孕非常和极度晚期的母亲年龄:一个意大利多中心的回顾性队列研究
Oumaima Ammar1, Maria Teresa Martini1, Sara Lazzarin2
1Division of Obstetrics and Gynecology, Department of Health Sciences, Careggi Hospital, Universita degli Studi di Firenze, Florence, Italy.
Acta obstetricia et gynecologica Scandinavica
|November 13, 2025
概括
45岁及以上妇女的辅助生殖技术 (ART) 怀孕与母亲发生诸如剖腹产和产后出血等并发症的风险更高有关. 在ART中使用异质卵细胞进一步增加了妊娠糖尿病和手动胎盘切除的风险.
科学领域:
- 生殖医学 生殖医学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产科 产科 产科 产科 产科
背景情况:
- 晚年孕产妇 (≥45岁) 的怀孕率正在上升,受助产技术 (ART) 的影响.
- 这些怀孕的产科和围产期结局需要进一步调查.
- 在晚期孕期中,专注于ART受孕和卵细胞来源至关重要.
研究的目的:
- 在45岁以上的妇女中调查单子妊娠的孕产妇和新生儿结局.
- 专门研究ART受孕和卵细胞来源对怀孕结果的影响.
- 为了比较自发受孕 (SC) 和ART之间的结果,以及同源 (ART-HO) 和异源 (ART-HE) 卵子细胞的使用.
主要方法:
- 多中心回顾性队列研究 (2016-2022年) 包括单独怀孕的45岁以上妇女.
- 按受孕方式进行分类:SC与ART.
- 根据卵细胞来源进一步分层的ART怀孕:ART-HO与ART-HE.
- 多变量后勤回归分析以评估与产科结果的关联.
主要成果:
- 与SC相比,ART怀孕的剖腹产 (aOR 4.20) 和产后出血 (aOR 2.72) 的调整几率明显更高.
- 在SC和ART组之间没有观察到新生儿结局的显著差异.
- 与ART-HO相比,ART-HE怀孕增加了妊娠糖尿病 (aOR 1.97) 和手动胎盘切除 (aOR 10.45) 的几率.
结论:
- 在45岁以上的女性中,ART怀孕与增加的孕产妇死亡率有关.
- 在ART中使用异质卵细胞进一步增加了特定母亲并发症的风险.
- 针对性咨询和多学科围产期护理对于这个不断增长的患者群体至关重要.
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